Code red

[Flatlandliver]

Originally Posted by blacknorthernjk

Truth.
Many rural services are integrated EMS/Fire. City of Edmonton is not. My original comment was directed towards Nube whom stated EFD was capable or doing almost anything an ambulance can, but I cannot for the life of me recall the last time I saw an EFD firefighter start an IV, intubate, decompress a chest, apply a traction splint etc. The skill sets are entirely different and they have the simplest most basic of life saving skills. Your AHS practitioners are highly trained and skilled with regular competency evaluations

Maybe let’s keep the paramedic vs firefighter bs off this site k.

[wildbill]

Originally Posted by CanadianPsycho

EMT/PCP here

Code red is when there is one or less ambulances available in a given region. It happens so often these days that it barely raises an eye-brow. When I was in on practicum in Calgary, over 1 month I think they had at least 10 code reds. Alot of them are stupid calls, you'd be amazed how often ambulances are called for someone with the sniffles, a stubbed toe, leg cramps (yes really, I personally attended that call), or a tooth ache. Any major call however will have an ambulance diverted off a routine call for it though. and usually when one place goes code red outlying ambulances will be brought in. For example, when Calgary goes Code Red ambulances will be brought in from Okotoks, Airdrie, Cochrane, etc.

One of the major issues is that once we pick up a pt we cannot leave them until care is accepted by equal or higher level of care. At large hospitals (Foothills, PLC, etc.) there is several ambulances arriving every hour along with walk in pts. Thats alot of people coming through and the beds fill up. Critical pts will be seen immediately, but if you bring in someone with a cold you will most likely be waiting quite some time in the hall. Meaning your ambulance is out of service. Sometimes one crew will monitor several patients while waiting, but that is dependent on the service and what brings the patients in.

Alberta actually has quite a few private ambulance services. For strictly EMS there is Guardian in rocky and whitecourt, Prairie EMS in the North East, Associated Ambulance, Stettler Ambulance, Caroline Ambulance and most Reserves run their own ambulances. For integrated services (both EMS and fire provided by one company) there is Strathcona Fire, Lethbridge Fire, Red Deer Emergency Services, and Fort MacMurray. And in most major cities fire fighters are trained to at minimum EMR level allowing them to at least support the pt until EMS arrives while not the same level of care it keeps people alive until EMS can transport or provide further interventions. fire is usually only dispatched to high level calls (think man down, cardiac arrests, difficulty breathing, major trauma events, etc). Almost everywhere else is AHS, which in my opinion runs a decent show. Could it be better, absolutely, but it does a decent enough job with the resources available.

Please forgive any rambling or weird writing. Just got off a 14hr shift.

Thanks for clearing that up, since the op was unable to

[blacknorthernjk]

Originally Posted by Flatlandliver

Maybe let’s keep the paramedic vs firefighter bs off this site k.

Misinformation requires clearing up else we have a general populace that has no idea what care providers responsibilities are. There is no b.s. presented on my behalf

[CanadianPsycho]

Originally Posted by FCLightning

An EMT can do all that?

For the most part, multiple drugs (nothing overly exciting though, no opiods or serious pain killers. Mostly symptom relief). IVs, traction splints. No intubations or chest decompression, both Advanced Care Paramedic skills. EMT do have King LT airways which are decent.

[CanadianPsycho]

Originally Posted by Iron Brew

Is there some sort of support for the EMT's etc. in regards to mental health? A friend from high school wound up taking his own life after years of ambulance work. Small town. Assumed to be PTSD. Very sad. He transported my dad when dad had a major stroke. I was never able to see him and thank him before he died.

Shockingly poor, its becoming more away with several high level awareness campaigns such as "we got you back 911" and what not. Stress Debriefings are becoming more popular. But mental health issues are still a serious part of the job and I would bet end dozens if not hundreds of careers a year. The stuff you see and do in this job do affect you, especially in the large urban centers where you are on the road all day every day. PTSD is almost common in the First responder field.

[Ken07AOVette]

Originally Posted by Iron Brew

Is there some sort of support for the EMT's etc. in regards to mental health? A friend from high school wound up taking his own life after years of ambulance work. Small town. Assumed to be PTSD. Very sad. He transported my dad when dad had a major stroke. I was never able to see him and thank him before he died.

We have a great County, any time we are at a loss of life call we are offered counselling both group and private as required. I have used group once, but in order for it to help you have to be open to it. Many 'tough guys' will show a brave face in public but suffer in silence.

[Twist]

Originally Posted by nube

Fire is actually there before an Ambulance on most calls. I think the stats are 67% but I could be wrong.
They will do almost anything an ambulance can but the main thing they can't do is give the drugs other than Naloxone.
A duel system like in Edmonton is the best care you can have. Fire has more stations and is usually closer to a lot of calls and if not available the next station will pick up the call which will be a few more min. away.

On a major call like a code the main Ambulance will be dispatched and usually a PRU fast response supervisor and then another ambulance.
I find a Min. of 5 people on a code call is best and there is a lot of work to do. It takes a team effort to get the job done to give the best service and chance for the PT. to suvive

Glad to hear the junkies will get better care. They're just on the verge of turning their life around.

[nube]

Originally Posted by blacknorthernjk

Rest assured an EFD firefighter does not have the same skill set as ACP or PCP paramedics. No requirement to maintain even the basic College licensing to be an EFD firefighter. Meanwhile your AHS Edmonton Ambulance service practitioners are required to re licence annually with mandatory annual educational requirements and individaul practitioner insurance.

Never said it was the same skill set but ..... well I better not say or you might get excited again..
And yes we actually do have yearly requirements and testing.....
And no we don't belong to ACP anymore and there is a reason for that....
And yes Paramedics are highly trained but I would say less than half of the staff in the city are paramedics.
For 90% of the calls a basic EMR levl is what is needed.
I would also add about 1/5 or more of the Firefighters in Edmonton are EMT level but are not recognized.
Not that it matters much. I am glad Patients get the best care possible with the system here. Not too many places you can have 6-9 people at your door in less than 7 min most times for the care they need. You won't get that in most Rural places that is for sure.

[FCLightning]

Originally Posted by nube

You won't get that in most Rural places that is for sure.

There's the understatement of the year.

[Battle Rat]

Originally Posted by nube

Never said it was the same skill set but ..... well I better not say or you might get excited again..
And yes we actually do have yearly requirements and testing.....
And no we don't belong to ACP anymore and there is a reason for that....
And yes Paramedics are highly trained but I would say less than half of the staff in the city are paramedics.
For 90% of the calls a basic EMR levl is what is needed.
I would also add about 1/5 or more of the Firefighters in Edmonton are EMT level but are not recognized.
Not that it matters much. I am glad Patients get the best care possible with the system here. Not too many places you can have 6-9 people at your door in less than 7 min most times for the care they need. You won't get that in most Rural places that is for sure.

A quick response time with a fighter fighter providing medical aid offers a far better chance of survival than a delayed paramedic.

[mattthegorby]

I am a strong proponent of paramedic training and expanding the scope of what paramedics can do, I feel they have an under utilizes skill set and the biggest thing we can do to strengthen the profession is to offer more opportunities for medical focused training and work specialization.

That being said, despite what one thinks about structuring emergency medical services as dependant on fire department first responder programs, there are many fire fighter EMTs that provide a level of care that is extremely high and in some instances, like motor vehicle incidents and technical rescue, have cross training that makes them an invaluable part of the team.

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[kevinhits]

Originally Posted by Battle Rat

A quick response time with a fighter fighter providing medical aid offers a far better chance of survival than a delayed paramedic.

x2....If I was in distress, just knowing any emergency unit is there asap would be more comforting for me, whether it is police, fire or paramedic

[nube]

Originally Posted by kevinhits

x2....If I was in distress, just knowing any emergency unit is there asap would be more comforting for me, whether it is police, fire or paramedic

I don't know what police have for medical training but it would be interesting to know. I walked into a scene once with a police officer doing chest compressions on a young man with a .45 cal. slug through his chest. First time I have seen them involved but he was part of the Tactical team so he may have had more training. It certainly wouldn't be a bad thing for police to be trained even to the basic levels.

[raab]

Originally Posted by FCLightning

An EMT can do all that?

EMTs can start an IV, interpret 4 lead ECG's, give Nitro, Ventolin/Atrovent, Entonox, and use an LMA or King LT. They should also know what to look for if a patient needs a needle de-compression, 12/15 lead, the stroke team, or intubation.

Paramedics can do more then I can type.



Now in saying that the EFD does great work, but they can't provide the same level of care as an EMT or Paramedic. Not because they'e incapable as many on the EFD were once qualified EMT's,Paramedic's, Nurse's. They just dont have the same protocols as an ambulance service has. I say once qualified because the training to keep up your EMT and Paramedic is ridiculous. Many are letting their licenses expire because of the cost associated with keeping it, and instead getting the MFR training. It's actually easier to keep up your continuing competency in nursing then it is for an EMT. Just insane

As for the code red situation. This is why I'd like to see some more privatization brought into the public sector. Our system is broken because we dont have enough long term care beds. What happens is someone goes into the Emergency. They're seen by a doctor and it's determined they're to sick to go home, but not sick enough that they need an immediate intervention. So the hospital will look for a bed for them. A lot of the time you'll have a patient in the ER taking up a bed for 2-3 days. Sometimes less sometimes more.

So now a bed that is designed to quickly get patients in and out is being taken up for long periods. This reduces the amount of beds available for the ER to get patients seen. Say your at the U of A that has maybe 30 beds(I dunno how many they actually have), and 10 of them are being taken up by people waiting for LTC beds. Now if we assume the average examination takes an hour. Well now your seeing 10 less people an hour. You look at the waiting rooms and theres usually less then 50 people waiting. So this is a substantial amount when it come to ER wait times. If we want more ambulances on the road instead of waiting in ER's. This is the fix.

Notley, and the NDP promised 1200 new LTC beds when they we're elected in 2015 to help fix the system. To date they haven't built one.(Not Surprised)

[raab]

Originally Posted by Battle Rat

A quick response time with a fighter fighter providing medical aid offers a far better chance of survival than a delayed paramedic.

Integrated service is the best method by far. Full protocols on a fire truck. Only problem with it, is that a fire truck doesnt get a patient to the hospital any faster. Sometimes the best intervention for a patient is diesel.

[raab]

Originally Posted by nube

Never said it was the same skill set but ..... well I better not say or you might get excited again..
And yes we actually do have yearly requirements and testing.....
And no we don't belong to ACP anymore and there is a reason for that....
And yes Paramedics are highly trained but I would say less than half of the staff in the city are paramedics.
For 90% of the calls a basic EMR levl is what is needed.
I would also add about 1/5 or more of the Firefighters in Edmonton are EMT level but are not recognized.
Not that it matters much. I am glad Patients get the best care possible with the system here. Not too many places you can have 6-9 people at your door in less than 7 min most times for the care they need. You won't get that in most Rural places that is for sure.

Yea, the joys of being a rural practitioner. Full cardiac arrest and your back up is 30 minutes behind you... Or 4 vehicle pile-up and your closest ALS back up is Stars. The city guys got it great, most calls at least 6 guys on scene.

[nube]

Originally Posted by raab

Yea, the joys of being a rural practitioner. Full cardiac arrest and your back up is 30 minutes behind you... Or 4 vehicle pile-up and your closest ALS back up is Stars. The city guys got it great, most calls at least 6 guys on scene.

Seems like you might know this but what are Rural areas doing for manning their Ambulances. Are they all ALS or are some still BLS service. Hopefully a medic is on every Ambulance. I know when I was on an ambulance years ago Edmonton ran mostly BLS but had a few roaming ALS Ambulances. I was lucky enough to be on it so I got to get a lot of good experience but didn't think it was the best system. I believe they are all ALS now but havn't really made it a priority to notice or not. I imagine a lot of the Rural areas are mostly BLS?

[raab]

Originally Posted by nube

Seems like you might know this but what are Rural areas doing for manning their Ambulances. Are they all ALS or are some still BLS service. Hopefully a medic is on every Ambulance. I know when I was on an ambulance years ago Edmonton ran mostly BLS but had a few roaming ALS Ambulances. I was lucky enough to be on it so I got to get a lot of good experience but didn't think it was the best system. I believe they are all ALS now but havn't really made it a priority to notice or not. I imagine a lot of the Rural areas are mostly BLS?

As far as I know still lots of BLS units around the province(Stocked to ALS level besides the drug pouches). They try to keep ALS units within a 45 minute intercept area IIRC. If your lucky they might actually be in station and not on a transfer to Edmonton when you need them.

Edmonton has both ALS and BLS units. The BLS units get back up from PRU's if they need it. Unless something has changed in the city, thats the last I heard about it.

[Battle Rat]

Originally Posted by raab

Integrated service is the best method by far. Full protocols on a fire truck. Only problem with it, is that a fire truck doesnt get a patient to the hospital any faster. Sometimes the best intervention for a patient is diesel.

For sure.
I've worked both sides of this where I'm giving patient care wishing rescue was on scene and other times doing extrication on wishing EMS would hurry up and arrive.

[Bushmaster]

Had coffee with the local fire chief this morning, they responded to a single vehicle accident just a mile from where I live last Friday. Single passenger and they called STARS and they refused to come !! Guy was transported to Provost Hospital and flown to Edmonton by Air Ambulance. Nobody was sure why STARS refused....could it have been the COLD weather(and concerns of fuel usage)? I know they have been here before.
And who would make the call to STARS...Ambulance attendant, Fire/Rescue ??

[Battle Rat]

Originally Posted by Bushmaster

Had coffee with the local fire chief this morning, they responded to a single vehicle accident just a mile from where I live last Friday. Single passenger and they called STARS and they refused to come !! Guy was transported to Provost Hospital and flown to Edmonton by Air Ambulance. Nobody was sure why STARS refused....could it have been the COLD weather(and concerns of fuel usage)? I know they have been here before.
And who would make the call to STARS...Ambulance attendant, Fire/Rescue ??

Could have been weather or availability. The AWs can make Provost from Edmonton but the old BKs would need to refuel somewhere on the home trip.
EMS, doctors and fire can all call STARs and request their response.
Recently a fixed wing responded the Hardisty when the helo couldn't fly due to the weather.

[nube]

Originally Posted by Bushmaster

Had coffee with the local fire chief this morning, they responded to a single vehicle accident just a mile from where I live last Friday. Single passenger and they called STARS and they refused to come !! Guy was transported to Provost Hospital and flown to Edmonton by Air Ambulance. Nobody was sure why STARS refused....could it have been the COLD weather(and concerns of fuel usage)? I know they have been here before.
And who would make the call to STARS...Ambulance attendant, Fire/Rescue ??

Fire or EMS in Edmonton can ask Dispatch to call. I've landed them twice in 17 years. Fire called both times but if they are needed then anyone can put the call in. Pretty impressive crew on those choppers!
They may not have come due to distance. There is a circle of coverage they can effectively handle. Also time from scene to hospital is a factor. If it's quicker for them to get a PT to a hospital using an Ambulance they will hich makes sense. I doubt by the time Stars got there then off to a hospital would have been quicker for this situation. They will get them to Hospital then stabalize then transport using air transportation on fixed wing or maybe chopper is what I think.

Raab -- the PRU has been a great thing as well in Edmonton. Very quick response and great to have someone on scene like that to help until and Ambulance arrives. We had a choking that turned into a code last week that didn't end well but the PRU beat us to the call by 30 seconds and usually they wouldn't have. Very good work was done and PT got her Pulse back after a couple shocks we gave but later died that night. Came close on that one. Usually tough to get a normal pulse back and thought she would have made it.

[Med Head 2]

Sorry this may be a long reply,

I have been in EMS for 24 years in all sorts of capacities from EMR/EMT/Paramedic/volunteer Fire Fighter. Through out the province but the last 18 years as a Paramedic with the City of Edmonton/AHS. There is multiple factors that now bite us in the behind with Code Reds. In I believe 2006 the province announced that they were taking over the ambulance services from municipalities. This did not take full effect until 2009. During that time some services did not put anymore money into the system but maintained status quo. From 2006-2009 Edmonton experienced a large population boom and substantial call volume increase. After 2009 it took a few years to for AHS to catch up, while trying to playing catch up, hospital times started creeping up( crews stuck in the hospital until the hospital took over. Crews would take 3-5 pt's at a time to facilitate shift changes and getting units on the road. Rapid response units(PRU) started be implemented as a stop gap. Getting patients thru the hospital is a multifaceted challenge not just long term care beds. Facilities need to be built staff hired and trained and the big one who will pay for all of it.

I can say 100% that the relationship between EFRS/EMS/EPS is getting better. In the early days we had more than a few confrontations between crews. It's not about who can do what or who's there first, it's we are all there for the patient. We (first responders) all have strong personalities and on the outside it looks like kids fighting for the parents attention but in the end we are all family.

Stepping off soap box(lol)

[jgib01]

Edit... maybe next time I'll read the whole thread before I reply to something on the first page. Sorry folks.

[JeanCretien]

Paramedic Jobs Edmonton
Hey- heads up to hunters and fishers. I’ve heard that they will be hiring EMRs and PCPs in Edmonton area for casual for AHS. PM me for details.


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[rem338win]

Originally Posted by Battle Rat

Could have been weather or availability. The AWs can make Provost from Edmonton but the old BKs would need to refuel somewhere on the home trip.
EMS, doctors and fire can all call STARs and request their response.
Recently a fixed wing responded the Hardisty when the helo couldn't fly due to the weather.

Any emergency personnel with STARS training can call and request assistance. This includes police, fire, ambulance, Sheriffs and peace officers.

[drhu22]

Nothing like a catchy title eh?

[^v^Tinda wolf^v^]

Originally Posted by CanadianPsycho

Shockingly poor, its becoming more away with several high level awareness campaigns such as "we got you back 911" and what not. Stress Debriefings are becoming more popular. But mental health issues are still a serious part of the job and I would bet end dozens if not hundreds of careers a year. The stuff you see and do in this job do affect you, especially in the large urban centers where you are on the road all day every day. PTSD is almost common in the First responder field.

Maybe this is a job for me I would say I have somewhat of a dexter type personality, you know that old chestnut, I enjoy breakfast too lol

[JeanCretien]

FYI AHS EMS Edmonton is hiring PCP and EMRs I hear there are postings up right now.


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[Kim473]

They really need to fix the system. Why do the ems have to waist countless hrs in hospital emergency when they could be on the road waiting for a call. All the hospitals need to get fixed at their end so the ems can get back to doing what they do best rather than waiting for the hospital to attend to patients waiting in hallways.